Work

Surgical Repair of Complex Coronary–Pulmonary Artery Fistulae With Concomitant Coronary Disease and Aortic Stenosis

Year: 2025

Type: article

Abstract: BACKGROUND: Coronary artery fistulae are rare anomalies that may cause myocardial ischemia or arrhythmias, even in the absence of coronary stenosis. Their presence alongside other structural cardiac diseases complicates diagnosis and management. CASE SUMMARY: A 69-year-old man presented with significant triple-vessel disease including left main stem involvement, moderate aortic stenosis, and complex coronary-pulmonary artery fistulae arising from all 3 coronary territories. He underwent urgent surgery comprising coronary artery bypass grafting, aortic valve replacement, and fistulae ligation. The patient had an uneventful postoperative course and made a good recovery. DISCUSSION: This case demonstrates how coronary-pulmonary artery fistulae, though rare, can significantly complicate clinical management when coexisting with severe coronary artery disease and valvular pathology. TAKE-HOME MESSAGE: Early recognition of coronary-pulmonary artery fistulae is essential, particularly in the setting of complex cardiac disease, where surgery may be the only effective treatment option.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105935

Authors: Bobby H.N. Chow, Ogadinma Mgbajah, Mazin A.I. Sarsam, Isaac Kadir, Eltigani Abdelaal, Ioannis Dimarakis

Institutions: Wythenshawe Hospital, University of Washington Medical Center, University of Manchester

Language: English

Topic: Coronary Artery Anomalies

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850